THIS IS A RELEASE AND WAIVER OF LIABILITY (“RELEASE”) RELATING TO ACTIVITIES INVOLVING MASSAGE THERAPY AND BODYWORK SERVICES OFFERED BY FUSION BODYWORK AND FITNESS LLC, A PENNSYLVANIA LIMITED LIABILITY COMPANY (“COMPANY”). PLEASE READ IT CAREFULLY. BY SIGNING THIS RELEASE, IN CONSIDERATION OF BEING PERMITTED TO RECEIVE SERVICES OFFERED BY THE COMPANY, I UNDERSTAND, ACKNOWLEDGE, APPRECIATE AND AGREE TO THE FOLLOWING:

 

1. Massage therapy, bodywork, and fitness can be dangerous. There is always a risk of injury from any such activities, which can be significant and include the potential for serious personal injury or death. While hygiene, equipment, and supervision are intended to reduce this risk, the risk nonetheless exists. By signing this release, I acknowledge that these activities are not meant to replace appropriate medical care.

 

1. I understand that the massage treatment(s) that I receive is/are provided for the purpose of relaxation, relief of stress, muscular tension, pain, and to aid the body with its natural healing process. A massage therapist works soft tissue and may integrate gentle range of motion exercises to the joints but will not administer spinal manipulations.

 

1. I understand that physical exercise can be strenuous and subject to risk of injury. I have been advised to obtain a physical examination from a doctor before beginning any fitness program. I understand that if the Company has not required a doctor’s release, and I choose not to receive one, my participation is at my own risk.

 

1. I confirm that I agree that I have provided the Company with an accurate and complete medical and health history. I acknowledge that to ensure appropriate treatment it is of upmost importance to inform my massage therapist of any old, current, or new injuries and that there may be additional risks based on my physical condition.

 

1. I have been given the opportunity to ask questions about massage therapy and/or bodywork services, and my questions have been answered to my satisfaction.

 

1. I understand that the Company may need to address areas on my body such as the inner thigh, upper leg, and/or side of the ribcage. The Company will have a conversation with me before addressing these areas, and we will make a mutual decision about how to proceed. If I am uncomfortable at any point, it is my responsibility to inform the Company immediately.

2. I understand that this procedure(s) may cause side effects.  The side effects listed here are merely examples and are not intended to be an exhaustive list.  Every person is different, and there is no guarantee that more severe side effects will not occur.  I understand the risks associated with massage therapy and bodywork include but are not limited to:

   1. Superficial bruising

   2. Short-term muscle soreness

   3. Exacerbation of undisclosed or undiscovered injury

 

1. If I experience any pain or discomfort, I will immediately inform my therapist so that the pressure or techniques can be adjusted to my comfort level. I will not hold my massage therapist responsible for any pain or discomfort I experience during or after the session.

 

1. I, for myself, knowingly and freely assume, all risks, both known and unknown, even if arising from the negligence of the Company and any of its officers, directors, members, employees, agents, representatives, contractors, affiliates, successors and assigns, or the other participants in the activities (each, a “Releasee”), and assume all responsibility for damages or injuries to person (including death or disability) or property, arising out of my participation in the Company activities. I take full responsibility for my welfare and safety and safety during participation in Company activities.  

 

CONTINUED ON BACK

1. I, for myself and my heirs, personal representatives, and assigns, do hereby: 

   1. release the Releasees from, and agree not to sue the Releasees for, liability for damages or injuries to person (including death or disability) or property, to the fullest extent permitted by law, regardless of whether arising from the negligence of any Releasees, which may arise from or relate to the massage therapy and bodywork services provided by the Company; and 

 

1. agree to indemnify and hold the Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorneys’ fees, with respect to any and all damages or injuries to person (including death or disability) or property, to the fullest extent permitted by law, regardless of whether arising from the negligence of any Releasees, which may arise from my participation or involvement in the Company activities. 

 

1. I further understand that massage therapy and/or bodywork is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware. I understand that massage therapists do not diagnose illness or disease, and nothing said during the treatment should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken.

 

1. I understand that I, or the Company may terminate services at any time.

 

1. I understand that the occurrence of any unwelcome conduct of a sexual nature which makes the Company or massage therapist feel offended, humiliated, and or intimidated is prohibited. If I engage in such unwelcome misconduct the Company shall immediately terminate services and receive payment in full for said services.

 

1. I have been informed and/or I am aware of the method of payment, the fee of the massage therapy and/or bodywork treatment as well as the cancellation policy. We require a 24-hour notice of cancellation, otherwise the fee for the full appointment booked may apply. 

 

1. This Release is intended to be as broad and inclusive as permitted by the laws of the Commonwealth of Pennsylvania. If any portion of this Release is held invalid, the balance of the Release shall nonetheless continue in full legal force and effect.

 

By signing this form, I agree to the conditions as outlined above, and I release the massage therapist and Company from all liability for any harm that may unintentionally result from this treatment.

 

HAVING READ, UNDERSTOOD, AND AGREED WITH ITS TERMS, I HAVE EXECUTED THIS RELEASE ON THE DATE SET FORTH BELOW, TO BE EFFECTIVE IMMEDIATELY.